What Happens at Your Medical Screening

Once you and an intended-parent family agree to move forward, the fertility clinic does its own clearance. Here's what that day (or two) actually looks like — and what each test is really checking for.

Published May 22, 2026 · Updated October 7, 2026

At your medical screening, the intended parents' fertility clinic does its own independent workup, which commonly includes an evaluation of your uterus (usually a saline-infusion sonogram), bloodwork and an infectious-disease panel, a smaller infectious-disease panel for your partner if you have one, and a psychological evaluation that is usually scheduled separately. The clinic visit itself is often a single day, sometimes two, depending on the clinic, the intended parents cover the costs including travel, and the process from scheduling to clearance often takes three to five weeks.

By the time you're booking your medical screening, you've already cleared the questionnaire, the Borne call, and the agency's intake. So this part can feel like a formality. It isn't. The fertility clinic does a separate, independent workup — and they're the ones who say whether your body is cleared to start cycle medications. Alongside your psychological evaluation and legal clearance, it's one of the key sign-offs before any treatment starts.

The good news: the screening is straightforward, almost everything happens in one or two appointments, and there's nothing to study for. You can't pass it harder by preparing. Here's what to expect.

Where the screening happens

The fertility clinic that's caring for the intended parents is the same clinic that screens you. That's true even if they're across the country — clinics will usually fly you in (covered by the intended parents) for a day or two of appointments, depending on the clinic. Much of the actual work often happens in a single morning. Bloodwork, ultrasound, and the medical interview are usually stacked back to back. The psych evaluation is typically scheduled separately, often by video.

The four things they're checking

Every clinic has its own checklist, but the workup falls into four buckets. Knowing what each one is for makes the experience a lot less mysterious.

1. Your uterus

The clinic needs to see, with their own equipment, that your uterine cavity is in shape to carry a pregnancy. They'll usually do a saline-infusion sonogram (sometimes called a SIS or sonohysterogram) — a quick ultrasound where saline is gently flushed into the uterus so the walls show up clearly. Some clinics use a hysteroscopy instead, which uses a thin camera. Either way, they're looking for fibroids, polyps, scarring, or anything else that could interfere with implantation. The test usually takes about ten minutes and feels similar to a Pap with mild cramping.

2. Your bloodwork and infectious-disease panel

This is the longest list. The infectious-disease tests on it are the panel ASRM recommends for every surrogate and her partner before transfer, and the clinic adds its own routine labs on top. Expect a draw of several tubes, commonly tested for the following (the exact list depends on the clinic):

• HIV, hepatitis B and C, and syphilis
• CMV (cytomegalovirus), which many clinics check as part of their own labs; most adults have been exposed to it - past exposure is fine, but an active infection means waiting until it clears
• Routine bloodwork: complete blood count, blood type and Rh, thyroid, vitamin D, fasting glucose, prolactin
• Immunity to rubella, varicella, and measles
• Drug and nicotine screen (urine)

Chlamydia and gonorrhea testing (a urine sample or swab) and up-to-date cervical cancer screening are also commonly part of the workup. If you're due for a Pap under ACOG's screening guidelines, the clinic will typically do it during the same visit, and a mammogram may be part of it too if you're due for one. Many clinics also ask that your vaccinations be current.

3. Your partner, if you have one

If you live with a spouse or partner, the clinic will ask them to do a smaller version of the same infectious-disease panel — usually including HIV, hepatitis B and C, syphilis, and a few others. ASRM recommends this for every surrogate's partner - it's not a judgment of your relationship. The draw can typically be done at a local lab and faxed in.

4. Your mental health

The psychological evaluation is done by a licensed mental health professional who specializes in third-party reproduction. Your partner or main support person takes part too. For you, it has three parts. First, a standardized inventory — most often the MMPI-3 or PAI — which is often taken online and commonly takes about an hour and a half. Then a clinical interview, often by video, that commonly runs about 60 to 90 minutes, though the format and length depend on the evaluator. Finally, implication counseling, which your partner or support person joins: a conversation about the medical plan, the number of embryos transferred, the chance of multiples, prenatal testing, reduction and termination, your right to make choices for your own body, and what you expect from the relationship with the intended parents.

The evaluator is looking at the whole picture: that you understand what surrogacy involves and have realistic expectations, that you have stable support at home and are choosing this freely, and how your mental health history and any current medications fit with ASRM's guidance. That guidance lists current use of psychoactive medication, untreated or unresolved conditions, and a history of major depression or postpartum mood disorder among the reasons a candidate may be declined - so be open about any history of postpartum depression or other mood conditions, and the evaluator will talk it through with you honestly. Having been in counseling isn't a problem in itself. They're not looking for a perfect score - they're looking for someone they're confident can carry safely.

What happens if something doesn't pass

Three categories of issues come up most often:

• Something fixable. A polyp on the SIS, a low vitamin D, an immunization that's lapsed. The clinic will outline the fix (a brief hysteroscopy, a supplement, a booster shot), give you a timeline, and you re-screen when you're cleared.
• Something that requires a pause or a closer look. A positive drug screen, a result outside the clinic's tolerance for thyroid or glucose, a recently completed pregnancy that's still close to the postpartum window. The clinic will tell you what they need to see and when to come back.
• A hard no. Rare, and it's almost always something that would have been a problem before you ever applied — a uterine condition that isn't safely correctable, an active infectious disease, a contraindication that surfaced during the psych eval. In those cases, the agency and Borne are in the loop, and we'll talk you through what it means.

Most surrogates get cleared cleanly. The ones who don't almost always have a defined path back.

What gets paid, and when

Medical screening is fully covered by the intended parents, including travel. You're also reimbursed for lost wages if appointments fall on a workday. Some agencies pay a screening fee — usually a few hundred dollars — once the clinic clears you. Depending on your contract, base compensation often starts when you begin cycle medications, the next milestone after clearance, or at confirmed pregnancy. The full compensation range for first-time surrogates is $60,000–$75,000, and $75,000–$100,000+ for experienced surrogates, varying by state.

How long the whole thing takes

From the day the clinic schedules you to the day you get cleared, plan on roughly three to five weeks, though it varies by clinic. The bottleneck is usually lab turnaround on the infectious-disease panel (some tests take 7–10 days) and the psych eval write-up (another week or so). The clinic visit itself is often a single day, sometimes two, depending on the clinic - for example if you're flying in and they want a follow-up scan.